This is the long-awaited DVD debut from world-class physical therapist Dr. Charlie Weingroff and it’s an absolute monster.

Training=Rehab, Rehab=Training is a 12+ hour, 6-disc set shot on-location over a weekend at an Equinox Fitness Club in New York City.  It documents Dr. Weingroff’s continuing efforts to reinvent and redefine the language between the rehabilitation and performance enhancement training landscapes.  And while there are plenty of examples for those who just want the exercises, these DVDs are more about designing your own blueprints based on common rules that medical professionals and personal trainers should honor.

If you weren’t there, this puts you in the room for the entirety of an extraordinary voyage with one of the most influential and outspoken voices in the industry.  Training=Rehab, Rehab=Training will surely be an educational milestone and a must-have in the collection for every physical therapist, strength coach and personal trainer.

6-discs, over 12 hours!

Writes Charlie Weingroff—
The goal of my DVD set is teach non-medical professionals the SFMA with restrictor plates. There will be no breakouts, no manual therapy, and no treating pain.

I think it is a huge void where non-medical folks don’t have the tool(s) to work side by side with medical clinicians with the same template. Non-painful dysfunction is the FMS; you will learn how to get into those patterns with my DVD, and you will leave the painful patterns to those that are qualified. If that happens to be you anyway, all the better.

If — or since it was filmed last weekend, perhaps I can say when –  this comes to market, there will be a lot more explanation than just the SFMA.
Topics will be typical injuries you see when the joint by joint goes wrong, the core pendulum theory, and understanding the inner core.

But I also hope I am not going to disappoint anyone as this version of the material, like I said, will be the SFMA with restrictor plates.
There will be no breakouts, no manual therapy, and no mechanism to treat people with pain.

What I want is for non-medical and medical folks to be able to use the same template to answer one of the MAJOR things I don’t care for, which is folks using the FMS in the presence of pain. After this DVD, you will know how to start to unfold the roadmap when you work with someone in pain. But I will not be the ones to give you tools that you may or may not be qualified to use. I respect that many non-medical clinicians are quite capable particularly manual therapists with an exercise background. I just don’t think it is appropriate to potentially put a chainsaw in the hands of a 4-year old. It’s not the right thing to do, and it’s also not really possible to put into a DVD.

I thoroughly explain why the rules are so clear when the FMS yields pain, but also demonstrate how the SFMA can also take you to swings, deadlifts, get-ups, push presses, etc.

What should be very enticing is that when non-medical folks are working with people in conjunction with poor physical therapists, you will clearly be the one that gets that person back to function, not the PT.

6-discs, over 12 hours!

PLUS these 3 Bonus Products………………

BONUS #1
The Top Ten Trigger Points Every Health and Fitness Professional Should Know

Dr. Perry Nickelston, DC from Stop Chasing Pain reveals a small portion of his revolutionary RRTT™ Recovery and Regeneration Program created by Dr. Perry. He will show…..
How trigger points cause dysfunctional movements
A system for evaluating these points in every assessment
Targeted protocols for eliminating these points
Pain compensation patterns
Why stretching makes them worse
Targeted hip and shoulder points

BONUS #2
The “Optimal Self Myofascial Release” E-Manual

Performance Expert Mike Robertson shows you the tried and true soft tissue methods and techniques he uses and has taught many others to use with their clients and athletes.

BONUS #3
Top 5 Glute Exercises
The Glutes are so often a limiting factor to both elite performance and back and knee pain.  Strength & Conditioning Expert Bret Contreras has compiled his top 5 Glute Exercises guaranteed to maximize your speed & power and foundation for a corrective approach.

Training = Rehab, Rehab = Training, 6 discs, over 12 hours for $197. The product page is on the right side panel right above the front cover of the DVD set.

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Case from an accomplished Physical Therapist bouncing some ideas……

Just eval’d a girl today: 27 y/o, hx of L acetabular labral tear (no repair), moderate pain throughout hip, but was recently dx’d with a brain tumor in her motor cortex leading to significant L foot drop.  Her main complaint is L posterior knee pain ( her AFO causes a ton of hyper ext at her knee), and she gets moderate hyperextension at her knee without the AFO. Good proprioception but poor kinesthetics (she can’t hit a target on the floor with her foot, but with her eyes closed she had very good proprioception of her hip and knee). She gets a lot of ER while performing prone hip ext on the L. I have her working on eccentric knee control with prone HS curls, and bridges with ball between legs to emphasize IR with hip ext ( I know using the thoracic spine as point of contact isn’t the most functional position, and a ball between the legs usually is not recommended d/t enforcing valgus at the knees), but I didn’t know where to start with her. Her main concern right now is her knee pain and her gait patterning. She is aware of motor control and learning and is afraid her body is going to learn poor motor patterning as a result of the foot drop. I also have her doing timed half kneeling to challenge her core, and pelvic stability, and a kneeling HF stretch. My main concern is teaching her a gait pattern that reduces the hyper extension at her knee. If you have any experience with anything like this, I could use some help.

Here are some thoughts.

1. Temper expectations. That doesn’t mean give up or half ass it. That means to have a very healthy respect to brain lesions. These lesions are tangible.  I have a hard time with affecting conditions with these types of sequelae unless you are named Kolar, etc.  In this case a tumor is a battle that someone else will have to win for you unless you know how to do brain surgery. Methods and results you are used to getting may not be so quick and ready when you are going up against something like this.

2.  Regarding prone curls and bridges with a ball, can I say, “Come on, man?”
Now, prone curls are not the worst of it, but I see this option as something for a Day 1 HEP for a spinal fusion.  Utilize the length changes in the anterior hip to control the pelvic tilt.
If the hamstring is what I’m after in a very remedial away, let’s go hip hinge and progress into DL.
If you can’t get there, then how about a very, very mild GHR.  Here’s how you set it up.  If you have a 45 Degree Hyper, prop it up so it becomes like a 15 degree hyper and lower the pads so they are even with her knees.  The feet are stabilized with the foot plate or pad down there, so the foot drop is minimized.  She can work into neutral from the neck, lumbar, and pelvis, and drive the knees into the pad for the GHR movement.  This is a brilliant approach for regressing the standard parallel to the floor GHR.
Let’s think a slow shuffle.  We can define a forward shuffle as a pattern in which the swinging leg does not cross the stance leg into a new stride.  The back leg only goes as far as the front leg before the front leg moves forward again.  It’s a gallop.  We need left leg forward, and the focus is the pulling of the rest of the body to narrow double leg stance with hip extension of the front leg.  Use a cane or crutch on the right side if needed, or go the other direction and load up that side to create an RNT to stay on the left side.  This is really a fantastic regression of SLDL for rehab folks.

3. A lot of neurological training techniques are hunt and peck as I see it. Some PNF “tricks” may work. Others may be useless. To facilitate DF, think D1 flexion. Try banded and hook handed resistance @ the hip and knee.  Try in single-leg stance as well with core activated.  Think unloaded – unloaded wth core activated – loaded – loaded with core activated.  Every corrective approach will fit into that systematic thought process courtesy of Gray Cook.  As an aside, his more recent publishings will be in the SFMA refined approaches for the rehab folks.  I presented some of this stuff for the first time in public with Thomas Myers in October, and he went more in depth @ Titleist Medical Level 3 in Orlando a few weeks ago.
Back to neurological keyholes…….you can also try some forced position work with the D1 patterning.  You can try something like a plantar fascia sock that pulls the foot into DF and hope and pray the D1 pattern clicks into it. It’s worth a try.  I don’t remember if this is Bobath or Brunnstrom’s approach, but it would be combined with the irradiation principles of PNF as well.

4. Beyond the neurological limiting factors, think of setting up 2 separate sections of the training session. Work for a period of time on getting to the foot drop, but then ignore the foot drop. Train in positions that still target the weak link from a musculoskeletal level. Think of the drop foot as pain where you would not aggressively challenge it with exercise. Work the kneeling patterns where the knee, ankle, and foot are out of the equation. If her shoulders move well, you have a wealth of upper body choices that can drive core and hip stability such as chops and lifts with the bar, rope, bands, and medball, presses, halos, anything you can imagine, Just do it tall, and allow for success. Don’t let the foot and/or knee limitations get in the way.  Block it into DF and toe hyperextension for passive length always.

5. Try this one yourself. Hip hinge or box squat with a negative shin angle. Sit way way back. You will feel the toes extend and the anterior tibs fire to create the weight shift. You know the hip hinge is valuable, and then if you go “too far,” you may very well be facilitating the antagonists to the foot drop. Progressing to SLDL would be amazing here. But also consider the bent-knee hip hinge, which is a pure Westside box squat. Start down on the box and set up with a negative shin angle. You’ll get a lot of forward lean, and that’s okay here as long as the lean is not from the anterior pelvic tilt. Try this as well.

6. I know it can be hard when working in a traditional PT setting, but don’t spend 60 minutes working on foot drop. Hammer it with what tools you have and the ones you see working, but overall train this person. Train them like an athlete that has nothing wrong with them. She should be hopping and doing 1-leg squats on the other leg if she can. The body is a funnel into a drain. One funnel is clogged up right now, but if we can put more good things into the other funnels, I truly believe the drain can start to clear up. This does mean ignoring the foot drop for a good portion of the session. Try it.

7.  Try this product.  www.andante.co.il/smart.asp?cat=17&in=0.
I am the Director of Clinical Education, and it is an excellent product that you can do anything loaded with.  We just came out with aiPhone App with this.  It can also be used for any limited weight bearing or gait training patient.
For this particular young lady, it can be used in conjunction with an FES for the anterior tib in conjuction with the biofeedback during gait.  This will work for her.

7 Comments »

Several weeks ago, I received no fewer than 4 phone calls as a result of Dan John’s Dragon Door seminar (danjohn.net/) with the same line of questioning.  The topic was the positioning of the neck during hip hinge lifts such as the DL and KB Swing.  The questions arose since these individuals that I have coached were seeing a completely different approach to optimal cervical position during these lifts.  I teach what I call the neck “packed”, which is strong cervical retrusion with capital flexion.  It basically looks like you are making an unattractive double chin and feeling a lot of pressure in the cervical spine.

Indeed Coach John teaches, as many other elite Olympic Lifting coaches and RKCs do as well, protruding the neck as if to “look out to the horizon.”  I rewatched his Kettlebell and Olympic Lifting videos, and the message is very consistent to basically be the exact opposite of what I’m suggesting.

Now I could show a bunch of picture of elite guys in all the lifts demonstrating both of these techniques/positions in the lifts.  For every one showing one, there will be another picture showing the other.  Rather than get into, well “this guy” does it, so it must be okay, a never ending foray, I am fairly confident that I can explain why it’s valuable to keep the neck in the “packed” position.  What I struggle with is when this information is provided, there is not a point counter-point for looking out at the horizon.  What I can not accept is “We don’t see a problem.”  ”We don’t see a problem” is getting to seem more and more as a translation to “Wow, you’re totally right, but I don’t want to change what I’m doing.”

I’m going to try to tell you why my way is good with anecdotal results and soft science.  Usually the retort is just anecdotal results.  I’d like to hear why I’m wrong, or why what I’m saying doesn’t matter.

Thomas Phillips, a Senior RKC, myself, and Steve Pucciarelli @ Fit For Like in Marlboro, NJ have worked on this neck technique for at least a year, and in fact, this is not just a safety issue.  It’s a safety issue and performance issue.  Spinal stabilization as I will describe in a few ways below not only allows for a healthy buttress of the core, but that in turn allows for more hip mobility and in turn a more free expression of powerful hip extension.  It’s never a coincidence that the positions of integrity are also the positions that make a monster.  I believe Tom has expressed these same thoughts to the RKC crowd for some time.

Some things to consider (from a post on StrengthCoach.com).

1.  The neck must always demonstrate physiological range of motion: flexion, extension, rotation, side bending.  But when considering an aggressive hip hinge like the Swing or DL, there is 1 long spine.  We hear long spine, tall spine very often as a global cue in how to set the core.  When you consider the spine as 1 entity, 1 chain of links with regions that are easier to move than others, we should consider that whatever happens in one of those areas will be compensated or met with a similar position elsewhere.  Basically what I’m saying is whatever happens in the neck is going to happen in the lumbar spine.

And if you saw someone Swing or DL with a hyper-lordosis, you would probably correct it.  Well, hyper-lordosis in the neck is the same thing as I see it.  And what feels like neutral or natural for most people is probably hyper-lordosis.  Almost all of us are always in some level of anterior tilt in the pelvis and cervical spine.  This anterior tilt creates bony approximation, and that bony approximation tells the brain, “Hey, we’re good down here.  We have stability from bones being closer togther.  We don’t need any inner core.  You guys can take a break.”

Think of the natural curves of the spine.  They are the way they are to balance other and resists compression and accomodate shear.  The spine is a pogo stick so when forces travel up from the floor, there is a springed attenuation.

If you increase the curve up at the neck with extension, that natural compensation is 1) maintain the anti-compressive spring and 2) increase the curves at the lumbar spine and thoracic spine to balance out the weight shift.

So if you look out at the horizon, you are DEstabilizing the neck, and that will trickle down to the lumbar spine.  There may not visually appear to be a correction required, but this is the makings of a high-threshold strategy.

2.  This 2nd point is a more lay approach.  Try this little experiment.  Stand firmly with a long spine and chin tucked hard.  Do this up against a wall and try to wiggle your head as high as you can.  You will be in the neck position I want.  And by the way, if you try stretching the hip flexor in 1/2 kneeling with this neck position, you’ll be more of a believer.

Now brace the lumbar spine as you see fit.  Have someone shove you while you try to hold your ground.  You will feel strong and stiff.

Now let your neck go relaxed.  Brace again, but keep the neck relaxed and just let it extend a little bit.  Trust your partner to shove you again with the same exact force.  Take a 3rd shove with your neck extended at the same angle where it would be looking at the horizon.  You will not take the shove as well as you did with the neck packed.

So if you are weaker with neck extended in standing, why would you want your neck extended in the gorilla position or in the hole of a hip-snap when you need stability and integrity the most?

3.  Allowing the neck out of centration in a dynamic stability effort inhibits the deep neck flexors.  The SCM and scalenes should be secondary stabilizers as their role and development phylogenetically are not to hold the neck still, but rather allow for fast twitch rotation or motion when necessary to detect of avoid danger.  Inhibiting the deep neck flexors is a HUGE mistake as then the reflexive core of diaphragm, multifidus, TA, pelvic floor will also be inhibited.  This is quite evidence-based.

This doesn’t mean these muscles don’t turn on.  It means they are inhibited and have a delayed pattern of activation.  This is Hodges, Kolar, Dalcourt, many others, and I think Gray and Kyle would say the same as well.  Without the primary tonic stabilizers timed well, the body goes to a high threshold and form closure through L5-S1.  This is what I described above from a different point of view.

Decentration of the neck can also foster scapular instability.  With the neck poorly stabilized, the T-spine approximates ever so slightly into flexion, and the scaps ride up a little big, and the lower trap is inhibited.  Yes, I believe this all comes from letting your neck slide back a little bit.  It does matter.  It does.

4.  Try another experiment.  Lock neck back the way I want you to.   Take a few deep breaths without losing the neck.  Now try with the neck extended.  I don’t think many people will honestly say it feels the same.  The breath will be bigger and less tensioned with the neck packed.

When you keep the neck packed, with practice the hinge will be more natural, just like when you use the dowel with the MRE/LRF hand hold position.  We try to correct the hip hinge with this neck position, the neck position when you can breath more freely and classic, and then give it away when you add load?  Also if you keep the neck packed, the bell swings towards the private area as desired.  The gravity towards the “squat swing” is greatly diminished.

You can try this position in pushups, planks, chops/lifts, ASLR.  You will find that the technique like ASLR improves greatly, or the pushup becomes much harder.  Many will suggest this neck position limits power production, and I agree……..in the beginning.  It will take practice to remodel the motor plan that is grounded in strength and speed.  Teaching this neck technique for a novice lifter will get them out of it much quicker.  The fact of the matter is that Tom and I have gotten PRs with our people in NJ after months of this position in the Squat and DL.

If you can breath easier amidst an awesome expression of stability and strength, there is a harness on a power source not accessible without the packed neck.  The more neuromuscular and biomechanical reasons are the same as above.

5.  Pulling the neck into retrustion or a tight glute squeeze is posterior pelvic tilting, not an end-range posterior pelvic tilt.  There is no reversal of the curve.  It’s actually bringing the pelvis and neck into neutral since I think most if not all of us hang in the -crossed pattern(s) to some degree.  This is where we get the common dull neck or low back soreness that even the most fit folks have.  It’s a very low level of bony approximation to “hang” on our postures.

When you consider packing the neck or squeezing the but, it goes back even to the stabilization protocols of Robin McKenzie in locking up the lower c-spine and fostering some upper cervical (capital) motion above C4.  This is the Joint by Joint in motion.  This integrity is tampered with even with a little extension.

6.  If you go back to that little shoving experiment, you can say the reason you lose stability is from the loss of vestibular input from a loss of vision.  You are correct.  But this loss of vestibulo-ocular (or spino-ocular) reflex can be restored with eye movement.

Instead of the neck moving into flexion and extension, the eyes follow the hip hinge.  Oral-facial drivers are enormous generators of hidden strength.  The eyes drive downwards on the descent of a squat or Swing, and they look up to the ceiling on the ascent.

Again, it is very, very hard to break into the firm motor patterns of such moves as Swings and O-Lifts, but the eye movements are worth huge firepower and tie in to everything else that I am talking about in terms of spinal stability.

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